Citywide Colon Cancer Control Coalition

The Citywide Colon Cancer Control Coalition (C5) is a group of public health professionals, clinicians, non-profit partners and researchers with expertise in colorectal cancer prevention that advises the NYC Department of Health in its mission to prevent and control colorectal cancer.

Since C5’s inception in 2003, the screening colonoscopy rate among adults ages 50 and older in the city has increased by 64% (from 42% in 2003 to 69% in 2017). The inequities by race/ethnicity in colon cancer prevention (PDF) evident in 2003 had been eliminated by 2010. In 2016, the New York City Community Health Survey found that among New Yorkers ages 50 and older, Asians/Pacific Islanders had significantly lower rates of timely screening colonoscopy as compared to either Blacks or Hispanics. No significant differences were found in rates of timely screening colonoscopy between Whites and other races/ethnicities. Despite our progress, further efforts are needed to reach the national target of 80% screened.

Initiatives

C5 provides content expertise and guidance to the Health Department on the messaging and dissemination of colon cancer public health education campaigns. These campaigns target both the general public and specific communities with low colorectal cancer screening rates. Past campaigns have included celebrity spokespeople on radio messages and poster ads in subway stations, bus shelters and public hospitals.

C5 advises the Health Department in the development of colorectal cancer screening guidelines specifically tailored to the local health care environment. These guidelines are disseminated to medical providers through City Health Information bulletins.

Primary care physicians can use the DERS form to assess their patients and identify those who are eligible for direct referral for colonoscopy. A referral that takes only one visit is more likely to result in a patient following through with a colonoscopy.

From 2011 to 2015, the Colonoscopy Quality Initiative (CQI) improved the quality of screening colonoscopies in the city and identified disparities in the quality of screening colonoscopies. The Health Department collected and analyzed data and disseminated aggregated performance reports to participating providers. Over the course of the initiative, nearly 300 endoscopists representing 21 sites reported site-level information on eight quality measures for roughly 95,000 screening colonoscopies. The Health Department also provided technical assistance to support accurate and complete data submission.

CQI is funded by the Centers for Disease Control and Prevention, the New York State Department of Health, and the Fund of Public Health in New York.

Summits

Since 2003, C5 summits have brought together leading professionals and stakeholders in colorectal cancer prevention and control. The summits offer an opportunity for experts at all levels of care to meet and develop new tools and initiatives to increase colorectal cancer screening rates in the city.

Committees

The Steering Committee governs C5 coalition operations, oversees subcommittees and provides recommendations to the Health Department. This committee also plans colorectal cancer prevention initiatives that stakeholders can implement in their respective institutions or programs. Additionally, it confirms new subcommittees, identifies new members and expands the reach of the City’s colorectal cancer initiatives.

The Community Health Center Committee works to improve access to appropriate, timely and quality screening colonoscopies for uninsured patients at community health centers. This committee supports the work of the NYC Community Cares Project.